It’s the ur-myth of lactivism, the belief that we came from Breastopia and we should return to Breastopia.

There’s just one problem: Breastopia never existed and frantic efforts to “reclaim” it are harming babies and mothers.

To understand why it helps to compare Breastopia to the natural world. That’s why I created the handy chart below.

In Breastopia every baby is breastfed, but in the real world many mothers died in childbirth and therefore couldn’t breastfeed. Many of these babies died.

Breastopia never existed and frantic efforts to “reclaim” it are harming babies and mothers.

In Breastopia colostrum is enough to support a baby through the first days after birth. In the real world many babies suffer dehydration, hypoglycemia and severe jaundice as a result of insufficient breastmilk. That’s probably the reason why indigenous cultures around the world offer pre-lacteal feeds. Many of these babies died.

In Breastopia a mother’s breastmilk production completely matches her baby’s needs. In the real world up to 15% of first time mothers don’t produce enough breastmilk to fully nourish an infant. Many of these babies died.

In Breastopia all babies can easily latch and can effectively suck. In the real world some babies can’t latch properly or have a weak, uncoordinated suck. Many of these babies died.

In Breastopia every baby “breastsleeps” with its mother, nursing freely throughout the night. In the real world many babies are smothered their mothers beds.

In Breastopia nearly all babies survive until weaning. In the real world anywhere from 20-40% babies or more do not survive their first year.

The clever among you are probably sensing a theme: breastfeeding, like any natural process, is far from perfect. As a result there are high rates of infant wastage. In other words, many babies naturally die in infancy.

Despite the fact that Breastopia literally never existed, many lactation professionals insists that we can and should return to it.

A new UNICEF report released Wednesday that ranks countries by breastfeeding rates shows that in high-income countries, more than one in five babies is never breastfed, whereas in low- and middle-income countries, one in 25 babies is never breastfed…

“The data and the analyses are a confirmation of a trend that we have seen for a number of years now,” said Victor Aguayo, UNICEF’s chief of nutrition, who was involved in the report’s policy analysis.

Aguayo bemoans the fact that many children are never breastfed and insists that we must make breastfeeding the norm.

“In higher-income countries, we see that the proportion of children who have never been breastfed is significantly higher than the number of children in low- and middle-income countries. That is a fact,” he said. “We need to create environments — including in the US — that make breastfeeding the norm.”

It’s almost as if he thinks breastfeeding makes infants healthier and saves lives. But that’s NOT what the data shows.

You can examine the full chart of international breastfeeding rates embedded in the article.

Let’s look at a few representative countries.

Afghanistan has a breastfeeding rate of 97.8%. It also has an astronomical infant mortality rate of 102.9/1000.

Burundi has an even higher breastfeeding rate of 98.8%. It’s infant mortality rate is also appalling at 81.1/1000.

How about the countries that UNICEF chastises for low breastfeeding rates like the US and France?

The US has a breastfeeding rate of 74.4% and an infant mortality rate of 5.87/1000.

France has an even lower breastfeeding rate of 63% and an even lower infant mortality rate of 3.2/1000.

Are you noticing a trend? That’s right, breastfeeding rate has NOTHING to do with infant mortality.

Moreover, as far as I know, there is no evidence that increasing the breastfeeding rate in a country leads to any measurable benefit in reduced infant mortality. The only exception to this is the case of very premature babies who have a reduced incidence of necrotizing enterocolitis when fed breastmilk.

None of this should be remotely surprising. Breastfeeding was far from perfect in nature and it is far from perfect now. Indeed, as I’ve written many times in past, the benefits of breastfeeding in countries with clean water are trivial, and not particularly compelling elsewhere, either.

So what’s driving the relentless pressure to increase breastfeeding rates? It obviously isn’t scientific evidence since no one can demonstrate any real world benefit to increased breastfeeding rates for term babies.

What’s driving it is the lactivist belief in Breastopia — the belief that Breastopia existed in the past and we could return to Breastopia in the future if we just offered greater support pressure to breastfeed. Lactivists are longing for a past that literally never existed. By relentlessly seeking to recapture it they are coming up against the real world limitations of breastfeeding … and seriously harming babies and mothers as a result.

It has become difficult to ignore the fact that breasfeeding may be responsible for the rise of allergies. They both rose together.

Roadstergal

There is a fair amount of evidence from interventional trials showing that exposure to food allergens at 4-6 months of age decreases the risk of food allergy. Therefore, it’s reasonable to hypothesize that the current messaging of “EBF for 6 months at the minimum” would indeed increase the risk of food allergy…

Daleth

Yes, we saw a study about peanut allergies being significantly higher the longer that kids were prevented from eating peanut butter. So ours were like 10 months old when I purposely fed them peanut butter for the first time. They loved it and have been snarfing it regularly ever since.

BeatriceC

I agree with Roadstergal. I think it’s an attribution error to blame breastfeeding itself. But delaying foods until six months, or even a year, has substantial evidence showing an increase in allergies.

Lisa Hayes

While it certainly can be dangerous if Moms who use formula in the poorest countries don’t have access to clean water and aren’t taught to fully boil the water. [Also American Moms who use the hot water tap]. That said, it can be just as dangerous to breast feed with HIV meds! I really do not understand this hysteria to strap a Mom to her baby 24/7/365 so it can nurse! Feed the kid. If he doesn’t nurse well–so what? Give him a bottle. A HEALTHY child is the goal, right?

MaineJen

One would think!

myndchanger fumblesmcstupid

Explain to me why the rise of breast feeding matches the rise if life threatening allergies like peanuts, wheat, cow milk, etc There was a study in Australia about 7 years ago that got shut down. I come from 3 generations of bottle fed and we are so healthy that it was opiads that killed my eldest brother.

But you can do everything “right” and still have a kid with allergies, or “wrong” and have a kid without allergies. There’s a difference between saying “this may reduce your risk” and speaking with contempt of children who have allergies, and to me “flowers” connotes contempt.

myndchanger fumblesmcstupid

Bull. It was not contempt, and you know it. My point was that the rise of breast feeding matches the rise of life threatening allergies. I don’t know why but I am very interested to know why there are no studies.

I’d like to see the point studied, too, but your posts came across as contemptuous toward kids with allergies.

myndchanger fumblesmcstupid

How?

Namaste

Guys, this is totally, 100% o/t, but I can’t seem to find squat on the Lisa Barrett case. Has anyone heard anything recently?

Anna

Caroline Lovell Homebirth Reform shared the latest article on FB. Trial still a while away.

Sue

The Adelaide Advertiser says “DECISION TIME FOR MANSLAUGHTER ACCUSED MIDWIFE
FORMER midwife and controversial homebirthing advocate Lisa Jane Barrett has eight days to decide whether she will challenge the manslaughter case filed against her.”

Megan

Funny to read this today. I just had our third baby via RCS today and as soon as we were in recovery I got my formula feeding “education” that formula powder is not sterile and shouldn’t be fed to babies under 2 months old and that if using powder we have to use hot water to sterilize the powder. I was very tempted to ask how many cases of cornybacterial illness she’s seen in term babies but I resisted. Ugh. I’m tired from surgery. Can’t I just be left alone?? I know how to formula feed.

Megan

Oops, I meant cronobacter. In case you can’t tell, I’ve had no rest since my section.

The Vitaphone Queen

Congrats! Boy or girl? Unless you would rather not share.

Megan

A boy! It was a surprise for us. My two daughters at home will be so excited!

Unfortunately, he developed tachypnea a few hours after birth and is in the nursery being worked up. I’m thinking and hoping transient tachypnea of the newborn but we’ll see. Tonight I just couldn’t keep it together. I miss my daughters at home and now I can’t even hold my son and I feel so helpless watching him struggle to breathe.

Not being able to hold your baby sucks. Hopefully, he’ll bounce back tonight and you can give him extra snuggles tomorrow.

Megan

I hope so. He’s on O2 now, Does indeed have TTN, which should resolve in a few days. I hope he improves quickly and he can be with us again.

Jessica

Hoping for the best and a quick return to you!

Sue

Hoping it all goes well very soon, and that he’s back to you in no time.

Empress of the Iguana People

*hugs* congrats! and you totally have a good reason to be tired today!

momofone

Congratulations!

Gene

Did you mention that breasts aren’t sterile either and no one recommends pouring boiling water on a nursing mother’s areolas prior to latching?

Megan

Oh believe me, there was lots I wanted to say but bit my tongue so she’d leave. Here’s the irony: they tell me that I shouldn’t be using powdered formula because it’s not sterile and to use it we need hot water so to heat up our water, she gets some random coffee cup to pour the sterile, now not sterile water into. *head desk

Gene

You are a much more diplomatic woman than I.

Empress of the Iguana People

Nostalgia is a dangerous thing, especially when golden ages never were so shiny when you were living in them.

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, Push Back: Guilt in the Age of Natural Parenting (HarperCollins) was published in 2016. She can be reached at DrAmy5 at aol dot com...
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